More and more women are having c-sections these days. About one woman in three now gives birth by cesarean. It's common to hear mixed messages about about risks and benefits of c-section as compared with vaginal birth. There is confusion and disagreement about the safety of vaginal birth, the safety of cesarean section, and the role that cesarean might play in preventing sexual and urinary problems.

Childbirth Connection has created a free downloadable booklet called What Every Pregnant Woman Needs to Know About Cesarean Section. This booklet provides trustworthy information and can help you understand what is at stake and work with your doctor or midwife to make the decision that is right for you. This section of the website contains more detailed information about the research comparing c-section and vaginal birth, as well as other resources and tips. You can learn about:

How you give birth to your first baby can impact your health and your baby's health in many ways. A first cesarean can also affect your health and your baby's health in future pregnancies. Visit our page called Best Evidence: C-Section for details about these and other risks that are different for cesarean and vaginal birth.

Because cesarean delivery has become so common, all pregnant women should learn about it. However, becoming informed is especially important for several groups of women:

If you are expecting your first baby: As a first-time expectant mother, you have the greatest freedom to determine the kind of birth you will have, and the choices you make for this first baby are likely to determine your available options for any future babies. If you have a cesarean for this birth, you probably will have a cesarean for any future babies because it is becoming more difficult to find caregivers and hospitals that support vaginal birth after cesarean (VBAC). This means that you and your babies will probably face the extra risks of repeated cesareans. However, if your first birth is a vaginal birth, you will almost certainly go on having vaginal births in the future.

If you might have more than 2 babies: The likelihood of certain life-threatening complications that could affect you and your future babies goes up as the number of cesareans goes up.

If you are expecting your first baby in your 30s or beyond: Women having first babies in their 30s are much more likely than younger women to have them by cesarean. Many of these excess c-sections are due to non-medical factors such as the false belief that planned cesarean is safer for babies. Women who are 35 or older also face a higher risk of certain complications of c-sections, such as excessive bleeding or blood clots.

If you are overweight or obese: Women of size are more likely to have a c-section than women with less body fat. High weight also increases the risk of certain complications of c-sections, especially infections and blood clots.

If you have had previous abdominal or pelvic surgery: Every operation increases the amount of internal scar tissue (adhesions) and therefore the problems adhesions can cause. These problems include chronic pain and a twisted and blocked bowel. In addition, when there are adhesions further surgery is more difficult and more likely to result in injuries to organs or blood vessels.

If you are considering planning a cesarean in the belief that it will prevent pelvic floor disorders, be sure to read our section called Pelvic Floor Dysfunction. This Pregnancy Topic covers in detail what is only touched upon here. There you will find research-backed information on the minimal degree to which c-section offers protection and many specific ideas, also backed by sound research, on how to prevent weakness and injury and relieve pelvic floor symptoms without resorting to major surgery.

We recommend you read VBAC or Repeat C-Section, which is our in-depth Pregnancy Topic for women who have already had one or more cesareans. If this is your situation, you will want a complete picture of the trade-offs between planning a vaginal birth after cesarean and planning a repeat cesarean section before making this crucial decision. In that section, you will find background information, lessons from the best research, tips you can take in pregnancy and while giving birth for lowering risks and increasing satisfaction, and resources for learning more, making your birth plan and reaching your goals.

If you have not had a cesarean, the VBAC or Repeat C-Section Pregnancy Topic can help you understand the dilemmas and options that pregnant women with a previous cesarean face.

Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.